Kentucky Primary Care A ssociation L egislative U pdate May 17, 2019
Overview: Session O verview L egislation & Issues - F ederal Report L ooking A head
Red Shirts & Rage
Session Overview By the Numbers: - House Controlled by GOP 61 -39 - Senate Controlled by GOP 29-9 2019 Regular Session - “Short” 30-day Session —Organizational Session - Convened January 8 & Adjourned March 28 - New Laws Become Effective June 27 - Top Issues: School Safety, Pension Reform, Tax Reform, School Safety & Social Issues - Organizational Session
Session Overview - O rganization House House Senate Senate GOP Leaders GOP Leaders - Speaker Osborne - President Stivers - Speaker Pro -Tem Meade - President Pro -Tem Givens - Majority Floor Leader Carney - Majority Floor Leader Thayer - Majority Caucus Chair Miles - Majority Caucus Chair Adams - Majority Whip McCoy - Majority Whip Wilson Democrat Leaders - Minority Floor Leader Adkins Democrat Leaders - Minority Whip Jenkins - Minority Floor Leader McGarvey - Minority Caucus Chair Graham - Minority Caucus Chair Turner - Minority Whip Parrett
House Health & Family Services - 19 members, 8 are freshmen Kimberly PooreMoser - (H) - Chair Danny Bentley - (H) Melinda Gibbons Prunty – (H) Tina Bojanowski - (H) Josie Raymond – (H) Adam Bowling - (H) Steve Riley – (H) George Brown Jr - (H) Steve Sheldon – (H) Tom Burch - (H) Nancy Tate – (H) Daniel Elliott - (H) Russell Webber – (H) Deanna Frazier - (H) Lisa Willner – (H) Robert Goforth - (H) Joni L. Jenkins - (H) Scott Lewis - (H) Mary Lou Marzian - (H)
Senate Health & Welfare ● Ralph Alvarado - (S) - Chair ● Stephen Meredith - (S) - Vice Chair ● Julie Raque Adams - (S) ● Tom Buford - (S) ● Danny Carroll - (S) ● Julian M. Carroll - (S) David P. Givens - (S) ● ● Denise Harper Angel - (S) ● Alice ForgyKerr - (S) Morgan McGarvey - (S) ● ● Max Wise - (S)
Session Overview - Political O verview - Teacher Unrest Continues - House Seat Contested - Major Pension Reform Never Considered - Quasi Pension Reform Controversy
Red Shirts & Rage —Part 2
2019 Session Issues - L ead Issues Big Issues Business Issues - Passed Big Issues - Failed SB 2 - Allow for venue SB 1/HB 1 - School Safety SB 7 - Arbitration Clauses change on civil actions - Employment Contracts HB 354/HB 458/HB 268 - Budget/Taxes SB 3 - School council HB 4 - Administrative reforms Regulation Reform HB 358 - Quasi -entity SB 5 - Move the state Pension Reform SB 18 - Accommodation elections to even years for pregnancy/childbirth HB 3 - Public assistance SB 57 - Felony reforms Expungement Expansion
2019 Session —H ealthcare—M C O ’s v. Providers; Public H ealth & C H F S Re-O rg.
2019 Session Issues – Providers v. M C O ’s Bills - Failed Bills - Passed -SB 139 — Pharmacy - SB 54 – Prior Authorization - SB 42 – Limit MCO’s - SB 110 – Credentialing Organizations - SB 112 – Medicaid Co -payments - SB 149 – Multiple External Reviews
2019 Session Issues – C H F S Re-O rg Bills - Failed Bills - Passed -SB 181 — Misc. re -org. - SB 167 – Health Info & Analytics - SB 182 – Licensure & CON - HB 513 – Substance Use Disorder
2019 Session Issues - Public H ealth Bills - Failed Bills - Passed -SCR 154 – Hep A Response - HB 11 – Tobacco Use & Schools -HB 136 - Authorizing Medical - SB 30 – Colon Cancer Screening Marijuana - SB 18 – Accommodations for -Several Bills to tighten age requirements, tax or otherwise Pregnancy/Childbirth restrict tobacco & vaping. -SB 84 – Licensure of midwives
Looking Ahead - Where we are now Where we are now ● Special Session on Pensions on the Horizon Special Session on Pensions on the Horizon Relationship between Governor and General Assembly Relationship between Governor and General Assembly ● ● Statewide Statewide Elections: Primary on May 21 Elections: Primary on May 21
FOR IMMEDIATE RELEASE: April 4, 2019 CONTACT: Barrasso Press Office (Barrasso) – (202) 224-6441 Molly Morrisey (Smith) – (202) 224-9857 Barrasso, Smith Introduce Bipartisan Rural Health Clinic Modernization Act Bill provides regulatory relief for rural health clinics and improves reimbursement rates. WASHINGTON, DC –Today, U.S. Senators John Barrasso (R-WY) and Tina Smith (D-MN) introduced the bipartisan Rural Health Clinic Modernization Act ( S. 1037 ). The bill provides regulatory relief for rural health clinics while also improving reimbursements for these important facilities. “As a doctor from a rural state, I want all patients to have access to high-quality care wherever they live,” Sen. Barrasso said . “Rural health clinics have a long record of making sure that folks in rural communities receive primary care close to home. I am proud to help lead this bipartisan effort to strengthen rural health clinics so they will continue to serve patients in Wyoming and across rural America.” “We need to do everything we can to make sure that people in rural areas are able to get healthcare,” Sen. Smith said . “While there have been significant changes in the health care system, many of the laws focusing on Rural Health Clinics haven’t been updated in over 40 years. Our bipartisan bill would fix some of the old rules that are in need of these upgrades. For example, it expands the ability of physician assistants and nurse practitioners to provide care in these clinics. This legislation is really about making sure at the end of the day people are going to be able to get the vital care Rural Health Clinics provide in underserved, rural areas.” Rural Health Clinics (RHCs) were established through the Rural Health Clinic Services Act of 1977. The purpose of RHCs was to address the shortage of health care providers serving in rural communities, including advanced practice clinicians. There are approximately 4,100 rural health clinics operating in the United States. Rural Health Clinics are an important part of the rural health care safety net, with facilities heavily dependent on Medicare and Medicaid reimbursement.
RHC Modernization Act – W hat does it do? Designed to pass, not to make a statement. Uncontroversial and cost free provisions Sec. 2 ~ Modernizing Physician, Physician Assistant, and Nurse Practitioner Utilization Requirements. Sec. 2 ~ Modernizing Physician, Physician Assistant, and Nurse Practitioner Utilization Requirements. Modernizes physician supervision requirements in RHCs by aligning scope of practice laws with state law. Allows PAs and NPs to practice up to the top of their license without unnecessary federal supervision requirements that apply only because the P A or NP is practicing in a RHC. Sec. 3 ~ Removing Outdated Laboratory Requirements Sec. 3 ~ Removing Outdated Laboratory Requirements Removes a requirement that RHCs maintain certain lab equipment on site, and allows RHCs to satisfy this certification requirement if they have prompt access to lab services. Sec. 4 ~ Allowing Rural Health Clinics the Flexibility to Contract with Physician Assistants and Nurse Practitioners. Sec. 4 ~ Allowing Rural Health Clinics the Flexibility to Contract with Physician Assistants and Nurse Practitioners. Removes a redundant requirement that RHCs employ a PA or NP (as evidenced by a W2) and allows RHCs to satisfy the PA, NP, or CNM utilization requirements through a contractual agreement if they chose to do so. Sec Sec . 6 ~ Including Facilities Located in Certain Areas . 6 ~ Including Facilities Located in Certain Areas Gives states authority to designate areas as rural for purposes of the RHC program.
RHC Modernization Act of 2019 – W hat does it do? Cost Provisions Sec. 5 ~ Allowing Rural Health Clinics to be the Distant Site for a Telehealth Visit. Sec. 5 ~ Allowing Rural Health Clinics to be the Distant Site for a Telehealth Visit. Allows RHCs to offer telehealth services as the distant site (where the provider is located) and bill for such telehealth services as RHC visits. Sec. 7 ~ Raising the Cap on Rural Health Clinic Payments. Sec. 7 ~ Raising the Cap on Rural Health Clinic Payments. Increases the upper limit (or cap) on RHC reimbursement to: -$105 in 2020 -$110 in 2021 -$115 in 2022 -And by MEI each year thereafter.
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